Low blood pressure while standing: Orthostatic Hypotension

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Submitted by Dr T on September 15, 2010 – 8:34am

Hi I’m 18, been in bed for the last two months with mono. When I stand I have a drop in blood pressure of about 20/10, I feel my head rush, my face gets hot, I don’t get dizzy, but after standing for awhile it goes low again, will this fix itself once my body adjust to being normal again or do I have to do something to fix it?

Your condition is called “Orthostatic Hypotension”, a form of low blood pressure that happens when you stand up from sitting or lying down. Orthostatic hypotension can make you feel dizzy or lightheaded, and maybe even faint. You probably also feel your heart beat much faster when you experience this drop in blood pressure. Both are a reaction to orthostatic hypotension.

Other Orthostatic Hypotension signs and symptoms may include :

  • Feeling lightheaded or dizzy after standing up
  • Blurry vision
  • Weakness
  • Fainting (syncope)
  • Confusion
  • Nausea
  • Headache

Because of the time you have spent bedridden, the muscles in your legs have become weaker. When you get up, gravity will pool blood at the lowest point in your body, your lower legs, causing less blood to flow back to your heart.  Your heart tries to compensate by beating faster and thus pump more blood. Your face getting hot happens because your head is getting preferential treatment because of your brain.

So far this is a normal physiological reaction to spending such a long time in bed. It will get better with time. In the meantime, take your time getting up and sit for a few minutes before standing. It will get better with time!

Some factors that may cause Orthostatic Hypotension:

  • Dehydration. Fever, vomiting, not drinking enough fluids, severe diarrhea and strenuous exercise can all lead to dehydration.
  • Heart problems. Any heart condition that decreases its function to pump blood around your body.
  • Anemia.
  • Age. As your body ages, the ability of special cells (baroreceptors) near your heart and neck arteries to regulate blood pressure can be slowed. Also, it may be harder for your heart to beat faster and compensate for drops in blood pressure.
  • Medications. Some medications such as high blood pressure medication have a greater risk of orthostatic hypotension. These include

    • Diuretics and other drugs that treat high blood pressure;
    • Heart medications, such as beta blockers;
    • Viagra, particularly in combination with nitroglycerin;
    • Alcohol.
  • Heat exposure. Sweating can cause dehydration.
  • Pregnancy. Because a woman’s circulatory system expands rapidly during pregnancy, blood pressure is likely to drop. This could cause blood pressure to drop enough to cause orthostatic hypotension when standing up quickly.

Tests may include :

  • Blood pressure monitoring while you’re sitting and during activities.
  • Blood tests.
  • Electrocardiogram (ECG)
  • Echocardiogram.
  • Stress test.
  • Tilt table test. A tilt table test evaluates how your body reacts to changes in position.

Treatments include :

  • When low blood pressure is caused by medications, treatment usually involves changing the dose or stopping it entirely.
  • Lifestyle changes. Drink plenty of fluids, such as water; limit your alcohol intake;
  • Compression stockings.

Hope this helps,


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